Exergame-based cognitive-motor integrated training: A novel approach to improving physical functions in older adults

Aging is associated with declines in balance, gait, and cognitive functions, increasing fall risk and diminishing quality of life. Exergame training, which integrates cognitive and motor tasks, has emerged as a promising intervention to address these issues.

The purpose of this study was to compare the effects of exergame-based training and conventional dual-task training on physical function in older adults.

Thirty community-dwelling older adults aged 60-75 years were randomly assigned to an exergame group ( $n=15$ ) or a dual-task group (n = 15). Both groups completed 30 min training sessions three times per week for 12 weeks. The exergame group performed interactive cognitive-motor stepping tasks with real-time visual and auditory feedback using the Dividat Senso platform, whereas the dual-task group performed conventional physical exercises combined with simultaneous cognitive tasks. Balance (surface area, weight distribution, and limit of stability) was assessed using a Physiosensing platform; gait (cadence, velocity, and stride length) was measured with a G-Walk sensor; and cognitive function was evaluated using the Korean version of the Montreal Cognitive Assessment (MoCA-K). Paired t-tests and analysis of covariance (ANCOVA) were used for statistical analysis. The study protocol was approved by the Sehan University Institutional Review Board (IRB No. SH-IRB 2025-006).

Both groups showed significant improvements across all measures ( $p<0.05$ ). The exergame group demonstrated greater gains in surface area, limit of stability, cadence, and velocity ( $p<0.05$ ), whereas weight distribution, stride length, and cognitive scores did not differ significantly between groups.

A 12-week exergame program yielded superior improvements in dynamic balance and gait speed compared with dual-task training, supporting its use as an effective strategy for enhancing mobility and preventing falls in older adults.